This chapter provides an overview of the techniques of inspection, palpation, percussion, and auscultation that are used throughout the physical examination. In addition, general use of the equipment for performing physical examination is discussed ( Box 3.1 ). Specific details…
This chapter discusses the development of relationships with patients and the building of histories or healthcare narratives. We write of it as “building” a history rather than “taking” one because you and your patient are involved in a joint effort,…
Achieving cultural competence is a learning process that requires self-awareness, reflective practice, and knowledge of core cultural issues. It involves recognizing one’s own culture, values, and biases and using effective patient-centered communication skills. A culturally competent healthcare provider adapts to…
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In Medicine it is always necessary to start with the observation of the sick and to always return to this as this is the paramount means of verification. Observe methodically and vigorously without neglecting any exploratory procedure, using all that…
Generalities This is a difficult area of physical exam, but one necessary in ambulatory medicine and often rewarding. One of ten patients presenting to a primary care office will do so because of musculoskeletal complaints. Most of these can be…
Generalities In times of magnetic resonance imaging (MRI) and computed tomography (CT), the neurologic exam may seem almost anachronistic. Yet, as the leading British neurologist McDonald Critchley (1900–1997) once said during one of his United States visits, “CT scanning will…
A General Considerations Lymph nodes are important. A methodical search may yield invaluable clues in cancer or systemic disease. Some “sentinel” nodes have even entered medical folklore, forever linked by eponyms to the physicians who first described them. 1. Which…
1. What is the role of the pelvic exam? To provide an essential component of the female exam, which, when well performed, allows for “low-tech” cancer screening plus the detection of various obstetric-gynecologic conditions – including pregnancy. 2. How can…
Generalities Examination of male genitalia and the rectum is an important but often overlooked part of the physical examination, usually conducted rather quickly at the end. There is no gain in being prudish about it (or, even worse, skipping it…